decisions

DECISIONS, DECISIONS

Savings passbook

My mom even saved our passbooks from our children's savings plan in grade school.

Going through some of Ken’s and my acquisitions I couldn’t help but be reminded of moving my mom and dad from their lovely country home in Sonoma County to the Bay Area.  It was my job to sort through and pack their house filled with years of accumulations.  My father was a collector of tools, but Mama saved everything.  When they arrived in San Francisco during the Great Depression, someone told her she should never throw away a receipt.  She didn’t.  I suppose she was allowed to toss grocery receipts, but for bills she saved every single paper marked or stamped “PAID IN FULL.”

With her Alzheimer’s already noticeable and my dad’s decision for them to move closer to me and Ken, I spent a week at their home packing, sorting and tossing.  My best advice to anyone living anywhere is to keep your files up-to-date and clear of any unnecessary paperwork.  It’s also the best gift you can leave to your children who will be responsible for the disposition of everything which has been left behind after you’re gone.  Mama literally had every receipt given  to her or my dad.  Drawers and boxes of them were filed in an orderly manner going as far back as the mid-1930s.  In addition, she had every bankbook ever delivered to any of us.

As I recall from my youth, we had bank day on Friday at our school.  To participate, we were issued our very own passbook, blue in color in its own pocket envelope. A little bigger than a cell phone the book was given to each student with his/her name placed on the first inside page with the name of one parent.  Into this account we could make a deposit of as little as a few cents every week.  A bank official was at the school to make the entry into the book which was signed and dated in neat, very legible handwriting.  This weekly ritual taught my sisters and me to be thrifty even during those economically stressful years.  Eventually, the total grew to a few dollars, but never more than $4. or $5. and, perhaps, a few odd cents before we advanced to junior high school. I suppose by then the banks had decided the practice was more bother than worth, and the accounts were soon forgotten by most students.

In my mother’s filing system, I found our passbooks stamped closed, the few dollar having been withdrawn by Mom – it was actually her money.  In addition to our canceled books were several closed savings accounts belonging to my parents as they became savvy about more advantageous ways of investing. The books, in addition to other obsolete transactions were, no doubt, saved because Mom considered them to be important records.  Accepting that she believed they were important, but not totally certain of her reasoning left a fragment of doubt causing me to question the obvious.  Consequently, I called each bank for closure verification as I cleaned and tossed.  Countless hours could have been saved if Mom had been “brave” enough to dispose of what was closed, canceled or no longer current.

One of Irene's saved pictures

She was also an artist in her own right, and I found so many pieces of early work.  Okay pieces – showing the structure of learning — not wonderful — but painted by my mother which tainted them with sentiment.  At first I thought I would save them, and then asked myself, “Why?”  They weren’t good enough to hang, so who would want them?  I decided it best not to ask, just do it: discard.   If her mind had been clear I would never have been so presumptuous, but she was in the first stages of a terminal mental illness. It was a fact, yet that same nagging thought kept running through my mind about the possibility of her waking up some morning and the AD would be gone.  I still haven’t figured out if that’s denial or hope.  Whatever it is, it’s somewhat of a nuisance – not only a nuisance – it can paralyze decision making.

So I made the decisions: item after item, file after file, sketch after sketch, painting after painting – I alone decided their fate. Keep it in case she remembers, or discard but don’t tell her?  It sounds so mean – so intrusive — but I knew Alzheimer’s already from caring for Ken’s parents.  Furthermore, no new strides had been made with the disease.  Mama would never even look for her old work. Chances were she may not have remembered even doing the selections I fretted over, much less the receipts, files or ancient bankbooks. Besides, I reassured myself, it was easier to discard, destroy, recycle, or donate while she was still alive.  I could get rid of what was useless, would never be missed or needed which would ultimately relieve me from some of the packing, moving, unpacking and sorting again once they were settled in their new home.  Respectfully, I did what I felt I had to do.

And then, eventually, one day when both Mom and Dad were gone and the remaining chore was to dismantle their home much of the difficult decision making had already been done.  Meanwhile, without so much “stuff” to manage and create clutter I could do what was most important: spend more time with them.  Now I am striving to apply that same philosophy as I continue to downsize the home where Ken and I have lived, loved and shared for more than a half century.  Wish me luck.

Originally posted 2011-08-20 19:06:44.

ACCEPTANCE: ALZHEIMER’S IS TERMINAL

The first week of November is a different time of the year for a 40th Class Reunion, but for whatever the reason, I was really looking forward to having our oldest daughter, Deborah, travel from Utah for the event and spend a few days with us, as well as her children and grandchildren.  She and husband, Mark, moved to Utah when he was downsized from his graphic arts job, located just south of San Francisco, with a package deal for an early retirement.

Wisely, they took their California money, retirement from her school teaching job and settled in Ogden.  The good part for them is they have several children who also live in Ogden; hence, grandchildren.  So wherever they are — Bay Area or Utah — there is family, but we miss them.

Our other four children, three boys and a girl (correctly put, it should read three men and one woman) live no more than an hour away from us, and that’s a good thing.  In the event of an emergency for either Ken or me, someone is only moments away.

Interesting, though, whether they live a mile away or 800 miles away, Ken doesn’t know any of them.  When Debbie arrived she greeted her father with a non-threatening hug and, “Hi Dad.  I’m your daughter, Debbie.”  He viewed her with suspicion and replied, “I don’t know about that,” which is similar to the same response he gives the others, even me.  His very brief moments of knowing me are sandwiched in between his mood swings amounting to not more than 10 to 15 minutes each day.

Even if the visit is lengthy it doesn’t matter; further recognition of his children does not take place as the hours move on.  All of us are just “someone” to him, as I was only “someone” to my mother as she slipped away into the more advanced stages of AD.  It was the same way with Ken’s parents, Rose and Nick; we were nobody, welcome nobodies, a few middle-aged people who kept showing up for a visit.  Their memory of family was and is gone.

I’m not sure if acceptance is an instant thing or if it’s gradual — probably a little of both.  When those first tears stop is that total acceptance?  Or is it when the patients look at the beautiful faces of family and sees them not?  I’m also certain that the timing is different for each family member.  Furthermore, acceptance isn’t just about the disease, there is always something new to accept as the victim spirals down the bottomless staircase.

In a recent response to my Blog, a follower mentioned that when the family fully accepts that Alzheimer’s is terminal, they could better come together in determining what is best for the victim.  That’s true, but, again, each case is very different and must be carefully evaluated.

For Ken’s parents and their particular situation and condition, we found it best to place them, at different times, in full-care facilities.  My mother, however, remained in the family home which included my father (with a live-in caregiver) until she took her last breath.  These decisions even in retrospect, for all of us, were what we believed to be best, not only for the AD patient, but for all concerned.

Never meaning to undermine the wrenching decision of children being called upon to put their parent or parents in a care facility, that relationship doesn’t compare to decades of intimacy and oneness shared by a husband and a wife.  Nor does anything compare to the agonizing decision reached by the well spouse who finally must declare, “Now is the time.”  And then, it is with support of family, all agreeing, that placement is necessary, which includes that which has already been declared and accepted:  Yes!  Alzheimer’s is terminal.

Originally posted 2009-11-11 08:18:50.

THE PARTNERSHIP

During those first blissful years of early marriage I rarely thought of the state of matrimony as a partnership.  How unromantic was that?  A partnership sounded like some kind of business deal and I thought of “us” as being more than that.   He was the husband and I was the wife.  Husband and wife were the important words as were the titles of Mr. and Mrs. on the outside of most of our addressed mail. 

Before we married I remember how exciting  it was to sit and doodle during spare moments; practicing the best way I was going to write my new name.  Flaring the M for the Mrs. part I then curved the K for Kenneth and looped the R in as many scrolling ways as could be imagined for our shared last name.  I was going to become Mrs. Kenneth Romick as my doodle paper would testify, and it wasn’t going to be some kind of business arrangement.

The “he” part of our marriage was a G.I. student and I was the working wife, but when we were home, it was togetherness.  We moved into our first San Francisco flat where we cleaned and painted the shabby place — together.   We went everywhere together; we played together; we shopped together, we cooked and ate together — then he studied and I cleaned up — not together. 

So, perhaps everything wasn’t meant to be together — but still we weren’t ready for a business partnership. Partnership in marriage, we believed, was like what our parents had: tired and worn, yet pulling together for a common goal; not always at their best with one another, but having it not matter; spending a whole evening together exchanging only a few words and that didn’t matter either.  Yes, they were comfortable partners and Biblically speaking they were  — more or less — equally yoked:  a team.   A team, we noticed, where one member sometimes pulled harder than the other, and then at other times it was the opposite member who pulled the load.

I always believed that our “Honeymoon” lasted longer than most couples we knew.  Even with the birth of our children we had our times of romance.  So, it would be difficult to say when during these past five-plus decades of togetherness we became a partnership, but partnership we became — without sacrificing the “us.”   However, I am certain that the younger generation has long-since viewed our marriage as old and tired and as comfortable as Ken and I once viewed the marriages of our parents.  What I have found most interesting during  these years of coping with Alzheimer’s is how much I miss the partnership. 

I had planned a trip to Washington state  in 2006 to attend the 50th anniversary celebration for long-time friends Julie and Bob.  The couple planned to renew their vows with me as the matron of honor, which I had been, and the best man planned to be in attendance as well.   I explained to Julie that we were planning on coming, but I had to make the decision on a daily basis depending on Ken’s condition.  Yet, I couldn’t wait until the last-minute to make reservations and route our trip. 

One evening I pulled up the Internet punched in motels for our stops and read what was offered.  Several looked good.  I asked Ken to sit with me and help decide where we would stay.  Together we had planned all of our previous vacations.  But with AD he had no idea what I was talking about especially viewing the screen and listening to the information I read to him; it all meant nothing.  I wanted his input — a discussion, to bounce ideas back and forth between one another, to hear what he liked or didn’t like — to help me choose.   He was incapable of helping and in the end, it didn’t matter.  The chosen motel was fine and the trip went well, but I missed my partner — my husband — my team member.

The motel decision wasn’t all that important, but it was an example of what was to come.  The responsibility of “us” is all mine; we are no longer equally yoked, much less a team, and our partnership is in name only.  Our roles have changed.  I am now the caregiver and he is the patient, and I care for him in much the same way as I would care for a child — a very difficult child — who at times is stubborn, explosive and unappreciative.  Although, every so often he is lucid enough to call me sweetheart.  If I’m fast and ask him for a hug, he complies, wrapping his arms around me as in days of old, and for a few moments we are “us.”  We are partners.

Originally posted 2009-08-04 06:20:20.

LITTLE DOG

She was a yappy little thing and had been leaving her calling cards on the lawn at our rental property.  I shooed her away and she ran off with her tail between her legs.  I felt bad because I didn’t want to hurt her feelings, but I didn’t want to clean up after her either.  “Do you know where the little dog lives?” asked one of the neighbors.  I told him I hadn’t seen her before and we both watched as she ran down the street seeming to know where she was going.

Before long we came to realize that she was either badly neglected, lost, abandoned when someone moved or dumped.  Over the next several weeks, I watched as she dodged cars, lapped her water from sprinkler puddles and licked what was left on carelessly tossed food papers.  “If I can catch her, I’ll keep her,” I told the neighbors who had also become sympathetic to the small stray, but no one could catch her.  She knew all the hiding places and all the escape routes in and out of the various yards.  She especially liked the back section of our rentals as most of our tenants were at work and she could spend the day sleeping under a bush with no disturbances — except for me and my helpers — and once we came into view she was gone.

Like Ken, I missed having a pet in the worst way and when old age and a stroke took the last of our beloved dogs, I decided that caring for Ken and our business was all I could manage, but I felt sorry for Little Dog.  So against my better judgement I borrowed an animal carrier from Sabina, my daughter-in-law, and set it near Little Dog’s favorite bush hoping if I put food and water inside she would become accustomed to a “cage” and make trapping her a possibility.  Sabina suggested that I cover the cage with a blanket to make it look like a “den.”  Water in a bowl was the first lure, but I carried a hand full of kibble.  Sure enough, the next day she was there, but viewed me with great suspicion.  I tossed the kibble from a distance, which she accepted.  However, as soon a I stepped forward she was gone.  I examined the cage with its “den” camouflage and decided Little Dog was no dummy.  She had pulled the blanket down and made herself a tidy bed, so I put it in the cage with more kibble and fresh water.   Apparently, she appreciated her new home.  Each day her bed was slept in and the kibble was gone.  After a week or so, if she was there, Little Dog  no longer raced off, often accepting my hand-held treats which she sniffed at until I gently tossed them in her direction.  Closer and closer she came until I could almost touch her, but if I reached out, off she ran.

She was almost like a feral cat and I wondered if there were feral dogs, but that made no sense; dogs liked companionship and people.  So what was her problem?   Perhaps I needed to rethink my intentions.  What if Little Dog was a tramp dog?  Supposing she was happy and wasn’t interested in being retrained?  Maybe she liked her carefree life, especially if she had a benefactor?   What if I trapped her, took her home, worked with her (when?) and Ken forgot, leaving the door open and she ran away?   What then?  Would I hunt her down and try it all again?

Meanwhile our daughter, Julie, called, “Mom, Can you watch our three dogs?  Tim and I would like to get away for a few days.”  It had been a while since her menagerie had come to stay, but I told her it would be all right.  One of their dogs was an escape artist so I knew I would have to be careful with Ken, making sure he never left the front door open; difficult, but manageable.  This would be a test.  If I could manage three dogs and Ken, I could manage Little Dog.

While in the past, Ken whistled at the back door for our dog to come, he wasn’t particularly interested in his three visitors.  Occasionally, he would reach down and pat one of them, but he wondered where they came from and why they were here.   His Alzheimer’s had removed the joyful camaraderie he had once shared with all dogs.  My thoughts these past years that, perhaps, a dog in our house would be good for him were no longer true.  The three canines were just objects to him, and I felt concern when they got excited.  It would be easy for Ken to trip and fall over one of them — if not all of them.   My decision those few years ago had been correct.  We were better off without a dog.  And Little Dog?  I went back to our rentals with kibble and a treat.   Her blanket had not been “nested,” and the kibble was scattered — probably cats.  She was gone.  No one had seen her.   I could have allowed my thoughts to drift to the worst case scenario, but I refused to go there.  Instead, I decided she had been lost, but now she is found.  In my heart, Little Dog was home.

Originally posted 2009-07-11 01:05:40.

ALZHEIMERS AND END OF LIFE DECISIONS

Hands touching on a bed.

One of the hardest decisions I ever made, choosing care and comfort for my spouse.

A VISIT TO THE ER

October 26, 2014 – When do we actually make life decisions? It was many years ago when both Ken and I were younger and much healthier than we have been these past few months. A long time before either of us thought about a life-ending situation. We were new grandparents back then with decades ahead of us when we would watch this new generation grow and develop as they rebelled and struggled, as did their parents, before reaching adulthood.

DECISIONS FOR THE FUTURE

It was one of those evenings when either my heart was palpating or Ken was having a Crohn’s disease attact that we entered the ER of our HMO hospital explaining our need to see a doctor and be evaluated.

Taking the needed information the admitting nurse then asked,

“Have you filled our your Advance Directives?”

“No,” one of us replied. “What are Advance Directives?”

Within a few minutes she had covered all the information they would like to have on file which would state our wishes if we were unable to converse with authorities at some later date. She then slid the forms across the counter for us to take home and fill out.

It was one of the most  important life decisions one can make. But admittedly, this was not at the top of our “To do” list so they were placed with another stack of papers to do later.

TIME MARCHES ON

And it was later, much later when I ran across them as I was going through stacks of papers as we do periodically when cleaning and tossing, especially the office.

I briefly looked them over once again and said to Ken, “As much as we want to ignore this, it is wise to get it done so the hospital will have them on file. We just don’t know what the future has in store.”He agreed, even though neither of us planned on leaving the planet on the next bus.” Our discussion suddenly became serious as we perused each section discussed these important decisions.

“If I can’t have a quality life, then I don’t want any heroic measures taken to prolong my existence,” he said. On that we both agreed

TREATMENT

So if there are no breathing machines, what do we want them to do was the question at hand? Did we want life prolonged with a feeding tube? Did we want a possible bout of pneumonia reversed with a treatment of antibiotics? A UTI infection?

We both agreed that there would be no feeding tube, but backed down again when it came to treating pneumonia and other infections. It was then that Ken remembered what he had said following the funeral of his parents as each had succumbed to Alzheimer’s loosing all memories and just lying in bed waiting to die, but not knowing it. “I don’t want to end up like my parents,” he had declared with absolute finality.

FINAL ANSWER

So when the ER doctor asked, “Do you want us to treat him with antibodics for his infections?” which had already been put in place. With my son, Keith, nearby, I said, “Remove the antibodics.”

“We’ll get him a room, and change the instructions to “Care and comfort only,” the doctor said kindly.

Those were the most difficult words I have ever spoken, but remembering his words of years before,” and having witnessed his illness for what seemed forever I knew we had made the right decision. He had already lived with more than 14 years battling Alzheimer’s. Heal the infections and bring him back to face more of the same? Why?

ALLOWING IT TO END

Allowing him to go and not have to continue the terrible journey into the dark corners of the AD dungeon was my final act of loving this man who had been everything to me for nearly 65 years. How could I not let his spirit soar back to God who is our home?

Originally posted 2014-10-26 15:04:15.

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